There are a number of myths about foot and ankle injuries that may prevent one from running to a doctor right away. We’ll try and dispel a few of them now:

1. “It can’t be broken if I can still move it.” False; this crazy idea has kept many fractures from ever receiving prompt, proper treatment. The truth is, often times you can walk with certain types of fractures. Some common examples include: breaks in the smaller, outer bones of the lower leg, small “chip” fractures of the ankle and foot bones, and the biggest one of all is the broken toe.
2. “If you break a toe, immediate care isn’t needed.” False; a toe fracture can require prompt attention. If x-rays show that the fracture is a simple displacement, where a little toe bone has just been shifted out of place, your podiatric physician can usually provide you rapid relief. In the unfortunate event that the x-rays show a “displaced” or “angulated” break, you need the help of a podiatrist to prevent improper or incomplete healing, which left untreated, can cause years of pain and trouble. There are times when the initial x-rays won’t show a fracture, even though it is there. In this case, it may be necessary to return at a later date to have a second set of x-rays performed. It is not uncommon for untreated toe fractures to develop into “post-fracture deformities”, which can lead to deformed toes that can generate painful corns and calluses in response to new abnormal pressures. In general, a good rule of thumb is: seek prompt treatment for injuries to your foot.
3. “You should soak your foot or ankle injury in hot water immediately.” False; never use hot water or heat on an area you suspect to be fractured, sprained or dislocated. Heat increases blood flow, which causes greater swelling. More swelling in turn means more pressure on the surrounding nerves, which causes more pain! Icing the injury, on the other hand, can have the opposite effect on blood flow, which reduces swelling and it has an added numbing effect, which helps with the pain. Upon examination by a podiatrist, additional recommendations may be given, based on your specific situation.
4. “Elastic bandages are an effective treatment for severe ankle sprains.” False; ankle sprains often involve torn or severely overstretched ligaments, and thus, they should receive immediate care by a physician. X-rays, immobilization with crutches or a boot and physical therapy may be needed to give you the best chance for a full recovery. It is possible that surgery may even be necessary, and you don’t want to delay this if you want to avoid trouble later in life.
5. “The words ‘Fracture’, ‘Break’, and ‘Crack’ are all different.” False; all of those words can be used to describe a broken bone.

Should you sustain an injury to your foot or ankle, there are a few steps you can take to help yourself until you can see your podiatrist. It’s an old saying, and many of you may have even heard it before, but it is often forgotten in times of trouble: “RICE”. “R” stands for Rest, meaning you should stay off your foot/ankle. “I” stands for Ice because applying ice wrapped in a towel over the injury for periods of 20-25min, followed by 45min of no ice can help limit swelling and help with the pain. “C” stands for Compression, as you can gently wrap an ACE bandage around the injury, taking care not to pull it too tight. “E” stands for Elevation, as you should sit in a position to keep your foot/ankle higher than your waist, which can also help reduce swelling. Remember, RICE is NOT a substitution for medical attention, it is just a few things you can employ before seeing the doctor.

Finally, there are a few precautions you can take to limit your risk of injury to your foot and ankle. Make sure you wear appropriate shoes for your chosen activities (in other words, don’t run a 5K in your dress shoes or sandals) and lace them up properly. If you need to wear steel-toed boots, make sure you leave enough room to accommodate your toes comfortably. Always wear closed toe, preferably hard-top shoes when mowing the lawn; and when you’re mowing the lawn, be sure to pay attention to what you’re doing! Don’t go barefoot on paved streets, even sidewalks. Watch out for slippery floors at home or work. Clean up obvious spills immediately. If you awake in the middle of the night, whether nature is calling or you suddenly remember your dog is still outside, you should turn on a light (or use a flash light). Many fractured toes and other foot injuries occur while walking in the dark.

Should you ever find yourself in need of medical attention for your foot or ankle, don’t hesitiate to contact your local Chandler Podiatrist immediately. We feel your feet are VERY important, and so should you!

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Chances are if you like going barefoot, if you enjoy swimming or if you frequently use public showers, you’ve had a wart on your foot. If you’ve had a wart before, implying you’ve since had it removed, you know it can take a long time and many doctor’s visits to finally vanquish that wart. A question you may be wondering is how your podiatrist can go about treating your warts, which is what we’re going to discuss in the next few paragraphs.

There are many topical solutions aimed at destroying the wart via direct application. These can often be found at your local pharmacy. Depending on which doctor you see, there are plenty of options to rid yourself of those hard-to-treat warts. Many doctors try freezing the warts off with liquid nitrogen (which is negative 320 degrees Fahrenheit). This extreme cold actually burns the wart, causing it to turn black and eventually fall off. If used properly, there should be no scarring with this method.

Doctors also try cutting the warts out in conjunction with electricity or ultrasound. First the area is numbed with medicine, then the physician uses an electrical or ultrasonic device to destroy the wart. After this, the remainder of the wart is removed with a tool called a “curette” (which is like a tiny ice-cream scoop). This technique is likely to cause a scar. A major problem with this method is that the scar can often be painful and there is a good chance the wart will return unless all of it was properly removed.

New technology has enabled doctors to use lasers to destroy warts. This procedure can actually be performed in a podiatrist’s office (provided they have the proper equipment). This is expensive however, and may result in some scarring. Because this is relatively new, it is still largely considered an unproven method.

One of the most common and successful methods is to burn warts off with a mild acid. The acid is applied topically to the wart, and many applications may be required over the course of several weeks to achieve positive results. While this seems excessive, this technique is highly successful.

While some of these treatment options seem brutal, primitive or unlikely to work, each of the discussed methods appears to have their place in medicine. Only you and your doctor can determine what is the best treatment plan to get rid of your warts. As long as the warts are on your feet, don’t hesitate to see your podiatrist to have them taken care of today!

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1. What can a Podiatrist do about Warts? Shouldn’t I see a Dermatologist?
2. Ingrown Toenails, How Does a Podiatrist Treat it?

Most of you probably know the pains involved with having an ingrown toenail. What you may not know, unless you’ve had this problem taken care of before, is how your podiatrist can go about treating the ingrown nail. In the next few paragraphs, you’ll learn about the treatment of ingrown toenails.

An ingrown toenail occurs when the sharp edge of the nail grows down into the skin of the toe. This usually causes pain, and may involve redness and swelling around the nail. When this happens, it’s usually a good idea to take care of the problem promptly. This will avoid prolonged irritation by the nail, which in turn can increase the chances of harboring infection, not to mention the longer you wait, the longer you’ll likely be in pain.

When you first see the podiatrist, they will assess how bad your toenail situation may be. If a simple trimming of the nail corner will relieve your pain, that may be the best approach. However, if your nail is severely ingrown and infected, this simple treatment won’t work and more invasive measures must be implemented. If this problem is new to you or is determined by your doctor to be a possible one-time occurrence your doctor may be able to simply remove a portion of the nail or your entire nail. This will allow the nail to grow back, hopefully coming back in a regular fashion without being ingrown. To do this, your podiatrist will probably numb your toe, and then remove your nail with some intimidating tools. There may be some bleeding, in which case your doctor or their nurse will dress your toe will gauze and possibly some antibiotic ointment. The numbing medicine will continue working for several hours, so your toe will remain numb. You may experience some pain the following day, but usually patients are able to return to their normal activities promptly.

If you experience recurring ingrown nails or your nail is ingrown as a result of a deformed toenail following trauma to the toe, then your best option is likely a permanent removal of the nail. In this case, your doctor will numb your toe and either remove the ingrown border of the nail or the entire nail (depending on how severe your problem is) using the same tools as a non-permanent removal described above. Then to make the removal permanent, they will use a chemical to kill the root of your nail so it will not grow back. There may be a little more pain involved with the recovery process of this procedure, but again, this won’t bother you until the numbing effect wears off in several hours. This pain is associated with the fact that the chemical used to kill the root of the nail actually creates a chemical burn that needs to heal. Despite the pain, which is rarely as painful as the ingrown nail itself, you’re usually able to resume normal activities right away. If your podiatrist decides a partial nail removal is appropriate, your remaining nail will appear normal, just slightly narrower than before. This is often the most aesthetically pleasing option because you’ll still have a nail left on your toe.

If you have diabetes, poor blood circulation, any kind of nerve damage, or an infection around your toenail, absolutely do NOT try to treat an ingrown toenail on your own. Go to your podiatrist right away. For the rest of you, while there are some home remedies for ingrown toenails that may work, it is usually best to see your local podiatrist, who as a foot specialist, is the most qualified doctor to deal with such a problem.

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If you have one or two toes that are shorter than the rest, and we’re talking significantly shorter, then there is a chance you have a condition called “Brachymetatarsia” (pronounced “break-e-meta-tars-e-uh”). This condition usually involves one of the five long bones in your feet (which are called the metatarsals) being abnormally shorter than the rest, resulting in a shortened toe. While it can occur on just one of your feet, it is almost always present in both feet, with the fourth toe (the one next to the littlest piggy) being most commonly affected. This condition can affect more than one toe, in which case it assumes a new name: brachymetapody.

Most of the time this condition will result from the growth plate in the metatarsal bone closing too early. Once this happens, the bone can no longer grow. There are multiple ways growth plates can close early, with the most common two being hereditary factors or trauma to the foot resulting in fracture of the growth plate.

Having a shortened toe can lead to numerous problems. When you walk, you normally transfer weight from your fifth toe on over to your first toe in a sequential manner (5^th, 4^th, 3^rd, 2^nd, 1^st). This motion works well for walking because your toes gradually become longer from the fifth to the first and as your weight is transferred from your heel to the ball of your feet, you start with the shortest toe and gradually transition to the longest toe for “push off” of your next step. The problem with having a shortened fourth toe, as is the case with Brachymetatarsia, is this process becomes disrupted. If your fourth toe is shorter than the fifth, as you transfer body weight during walking, the fourth toe is unable to accept the weight from the fifth toe, and you transfer incorrectly to the third toe. Jumping from the fifth to the third causes excess stress to be placed on these toes. As a result, pain can develop around the fifth and third toes. Another problem with an abnormally short toe is that it tends to drift upward on your foot, which can lead to problems with footwear and psychological distress from the appearance of your foot.

Treatment for brachymetatarsia is unfortunately limited. As is the case with many conditions, conservative treatment is often the first option. This involves wearing shoes with extra depth to allow more room for the shortened, raised up toe, as well as using padding to protect the toe from abnormal pressures from the top of the shoe, which can lead to the development of ulcerations. To relieve pressure under the other toes, you can use padded inserts.

When conservative treatments fail, surgery may be performed to lengthen the short toe. This procedure involves cutting the short bone and inserting a piece of bone graft between the two ends. Once the graft heals, the metatarsal and toe will be the correct length. Most of the time, associated tendons and surrounding skin must also be lengthened to accommodate the repaired toe.

In the event of an exceptionally short metatarsal, bone grafting may be impossible, in which case, the two adjacent metatarsals may be shortened slightly to recreate an arc of the toes, thus restoring your foot’s normal weight transferring ability. Following surgery, you will need to use crutches to avoid bearing weight on the repaired foot for close to 3 months. Then you’ll need to wear a snug-fitting lace-up shoe for an additional 6 weeks.

There are other treatment options, however these are best discussed in person with your doctor. If you have a “floating toe” or a noticeably shortened toe, you should seek medical attention from your local podiatrist soon. There are things that can be done to restore normal function and appearance to your foot.

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Osteoarthritis (OA for short) is also known as “Degenerative Arthritis” or “Degenerative Joint Disease,” and it encompasses a variety of abnormalities that all involve the degradation of your joints. There are different parts to a joint, but all are susceptible, such as the cartilage and bone. If you experience symptoms like joint pain, tenderness and stiffness, there is a chance you may have OA. There are a multitude of causes, whether it be hereditary, developmental, due to some underlying condition, or simply the mechanical stresses of being active, that may start the snowball effect of processes that can ultimately lead to a loss of cartilage. Without this important cartilage, the bone surfaces are less protected and bone may be exposed and damaged. Naturally, when this occurs, you will experience pain and as a result of this pain, you’re likely to decrease your activity level. This can lead to your muscles becoming “atrophied” or decreased in size and strength. Your ligaments may become more lax as well. In addition to the pain and muscle wasting, you may experience foot imbalances and problems in your ankles which can make walking all the more difficult.

Treatment of OA generally involves combining a variety of exercises, lifestyle modifications and pain medications. Often times this is just enough to get you back on your pain-free way. If your pain becomes debilitating, there are more invasive options like surgery to either replace the joint with an artificial piece or fuse the joint to eliminate the painful motion of bone rubbing on bone. These surgical options can improve the quality of your life, but they often depend on which joint is involved as well as other factors.

While it’s nearly inevitable to have pain as you age, there are definitely things your podiatrist can do to help you experience less of the painful aspects of aging, and allow you to focus on the joys of your experienced life instead.

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2. Your Feet After Fifty: Poor Circulation

The toes are the most distant part of the body from the heart. In order to supply blood to the foot, arteries must travel a great distance! To bring the “used” blood back to your heart, you have two sets of veins, complete with a complicated system of valves to prevent backflow against gravity. In our advanced years, many of these vessels can deteriorate. If this occurs, it may lead to circulatory troubles, which can lead to serious problems. Similarly to inadequate blood supply to the brain, heart and eyes, your feet can suffer dire consequences if they don’t get enough oxygen and nutrient-rich blood.

Some common signs and symptoms of inadequate circulation are listed below, each followed by a short explanation.

1. Swelling of the feet and ankles. This swelling can occur because fluid trapped in your legs has to go somewhere, so it leaves the blood vessels and collects in the surrounding tissue.
2. Cramps in the feet and calves while walking. The cramping may be due to inadequate oxygen supply being delivered to the muscles.
3. Inability to keep feet warm. Circulating blood is one way our bodies distribute and retain heat. Without proper circulation to your feet, they’re likely to feel cold, even if you wear several pairs of socks at a time.
4. Loss of fat tissue on the padded surfaces of the feet. Just like muscle or skin, fat is a living tissue, and without the lifeblood of circulation, it will wither away. A decrease in this padding will cause walking and standing to be more painful.
5. Chronic ulcers on the feet which fail to respond to treatment. Another important duty of blood and circulation is to carry different factors and “tools” to areas of injury to help in the healing process. Having decreased blood supply to an area like the foot is like having a damaged roof on your house, but no ladders to use in order to gain access to the roof to fix it.
6. Either no pulse or a bounding pulse in the arteries of the feet. A bounding pulse may suggest a blockage in the area, resulting in decreased blood supply to that area. A weak or absent pulse may be caused by heart failure, among other things.
7. Burning in the soles of the feet. This is related to problems with the nerves in your feet, and one cause can be decreased blood supply to the nerves and surrounding tissues.

By making an early diagnosis, your podiatrist can help prevent possible serious complications of having poor circulation to your lower legs and feet. If you’ve experienced any of the symptoms mentioned above, please call your local Chandler podiatrist for an appointment today.

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1. Your Feet at Fifty: Skin and Nails
2. Your Feet After Fifty: Arthritis

At every age of life, your skin is the first line of defense against infection. It keeps your insides in and the outside out. Without it you wouldn’t retain heat, you couldn’t repel water and you certainly wouldn’t be as attractive! Skin is vital to your wellbeing, and as such, it is important for you to guard it from injury and damage, especially on your feet!

In a previous post, we discussed how your blood circulation to your feet decreases as you age. Well, as this happens, various skin conditions tend to appear. When this happens to you, and your skin shows the effects of aging (as premature as it may seem), self care by either cutting or the use of store bought corn and callous cures can be the worst decision you’ve made in a while. These self-treatments aren’t to be taken lightly, as if you read the fine print, you may learn that they can produce severe disablement, and even loss of limb or life if misused.

The rate of growth and texture of our nails also becomes something to watch as we age. They start to appear thickened, discolored and somewhat powdery, or they can become paper-thin and brittle. No matter the change or cause, your podiatrist is the most qualified individual to treat both your toenails and the skin of your feet. They can monitor your progress and offer advice on how to make sure your skin is as well cared for as it has cared for you over the years. So, if you have noticed changes in the skin or nails of your feet, make an appointment to see your podiatrist today!

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While the exact incidence of pediatric flatfoot is unknown, it is common. At birth, virtually all children are flat-footed. This is not painful to the child, who is many months away from walking on their tiny feet, and it generally resolves without any treatment. It is quite rare that any type of corrective measures need to be taken. That’s not to say that treatment is never needed for other underlying conditions, which is why it’s not a bad idea to bring your child to a podiatrist if you’re concerned about their feet. There are various conditions that can be problematic if left alone for too long, but again, these are fairly rare.

The first question you want to ask yourself is: does my child complain of pain in their feet? If the answer is no, then you probably don’t need to do anything until they are a little older. To give you an idea, it is considered completely normal for children to have flat feet until they are 7 or 8 years old. Now, if your child does experience pain in their feet, it may be time to go see the doctor.

Before you ask your doctor to prescribe your child inserts for their flat feet, please consider this: what you put in your children’s shoes is not as important as what you put in their mouths. A rapidly growing problem in America is childhood obesity. While celebrities and political figures actively talk about this problem in the media, more doctors need to talk about it in their exam rooms with their patients. Abnormally excessive weight places unneeded stress on growing feet, and according to many studies places the child at higher risk to developing severe foot-related problems both immediately and later in life. The foot is a very complex structure, and obese children experience changes to that structure which create instability while walking. When a child’s feet hurt, they’re less likely to exercise, so providing a healthy diet is a good way to either prevent your little ones from gaining excess weight  or to help them lose weight if they’re already obese.

While obesity and flat-footedness are two different topics, they can be related. As always, it is important to see a podiatrist if you suspect you or your children are suffering from foot-related problems. Just don’t be surprised if they tell you your child’s flat feet are normal and no treatment is necessary.

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MRSA is simply an acronym for “Methicillin-Resistant Staphylococcus Aureus”. When you break it down, Methicillin is a type of antibiotic and Staphylococcus Aureus is nothing more than a type of bacteria. So, when put together, MRSA is just a type of bacteria that is resistant to certain types of antibiotics. Unfortunately for us, there aren’t a lot of good options for treating MRSA; however, fortunately for us, the ones we do have can be very effective.

There are, generally speaking, two types of MRSA: community-associated and hospital-acquired. These vary in ways other than the setting in which it is contracted, but these differences aren’t necessary to explain in this setting. What you should know is doctors have been diagnosing community-associated MRSA infections with increasing frequency.

Staphylococcus bacteria, or Staph for short, are common. In fact, 1 in 3 people carry these pesky bacteria. They live on your skin and in your nose and can be spread through skin contact. When this bacteria becomes a major problem is when it gets inside the body. Even minor tears in the skin’s surface open the door to bacteria and infection. Common skin conditions such as athlete’s foot, calluses, corns, eczema and psoriasis can create these open portals in the skin for bacteria to enter the body. Walking barefoot increases the risk of cuts and puncture wounds. Here are a few simple steps you can take to help prevent community-associated MRSA infections: Wash cuts and cover them promptly with a bandage, see a doctor within 24 hours for any puncture wound, never perform “bathroom surgery” to cut or dig out  an ingrown toenail or foreign body (like a splinter), and keep your feet clean and dry to prevent fungal infections like athlete’s foot.

Hopefully you have a better understanding of MRSA now. The best thing to do if you have an infected cut or scrape on your foot or ankle that doesn’t heal in a timely fashion is to see a podiatrist and get it checked out.

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WebMD asked some experts about ShapeUps. A podiatrist they spoke with has concerns about these sneakers. She thinks they could perhaps be a good fit for people with heel pain because of the way they cradle the heel, but they are definitely not for people with arthritis or any other foot problems for that matter. The fact that these shoes change the mechanics of the foot can be detrimental to people who aren’t completely healthy.

A group of personal trainers, in the same WebMD study, advised that for people who want to use these shoes, their recommendation is only to use them for outdoor walking. They say these shoes are not to be worn on a treadmill, while running or during weight-training because they are unstable in the ankle and increase the risk of injury. They feel one potential positive of the shoe is improved posture and increased muscle tone.

The FitFlop sandal is designed and tested at the Centre for Human Performance in London, and has become increasingly popular among consumers seeking the same benefits as ShapeUps. The premise behind these shoes centers around the company’s trademarked “Micowobbleboard technology” which, similar to the ShapeUps, is designed to increase the amount of time the leg muscles are engaged while walking. By creating an unstable platform, the body must exert more effort to maintain balance. The company claims these sandals can reduce back and ankle stress, realign force through the body while walking, and activate leg muscles by up to 30% more than traditional shoes. These claims are based on research conducted by the company on 15 women. This is an incredibly small sample size to declare this shoe works for the entire world’s population, which is why the UK government has given FitFlop Footwear 2 years to continue research on the benefits of the FitFlop and their Microwobbleboard technology. FitFlops have received the Seal of Acceptance from the American Podiatric Medical Association (APMA) which is awarded to companies whose products have been shown to promote foot health.

People with foot problems should consult with a podiatrist before purchasing a pair of ShapeUps or FitFlops to fix any problems they have with their feet. Buying new footwear can lead us to become more motivated to exercise and to live a healthier lifestyle. But you must remember, no piece of footwear can help you lose weight and gain strength without actually putting them on and doing some real work! So if a new pair of shoes will help you become more active, then try a pair of FitFlops first, as they

are approved by the APMA. Never hesitate to consult with your local Chandler Podiatrist about your feet because feet is what we do!

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